| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 N WINSTON RD KNOXVILLE, TN 37919 | CIGNA HEALTH ADN LIFE INSURANCE COMPANY | $83K | — | $83K | 9.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | PO BOX 10328 KNOXVILLE, TN 37939 | PRUDENTIAL | $41K | — | $41K | 13.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 N WINSTON RD KNOXVILLE, TN 37919 | DELTA DENTAL OF MISSOURI | $16K | — | $16K | 9.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 N WINSTON RD #100 PO BOX 10328 KNOXVILLE, TN 37919 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.41% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.23% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $818 | — | $818 | 2.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 N WINSTON RD #100 PO BOX 10328 KNOXVILLE, TN 37919 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $362 | — | $362 | 0.95% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN RD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$4 | — | -$4 | -0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | 1900 N WINSTON RD KNOXVILLE, TN 37919 | ADVANTICA INSURANCE COMPANY | $3K | — | $3K | 10.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICE, INC. | PO BOX 10328 KNOXVILLE, TN 37919 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | — |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $44 | — | $44 | — |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 674 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 674 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH ADN LIFE INSURANCE COMPANY | 481 | $851K |
| Dental | DELTA DENTAL OF MISSOURI | 674 | $173K |
| Vision | ADVANTICA INSURANCE COMPANY | 541 | $31K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL | 663 | $350K |
| Short-term disability | PRUDENTIAL | 663 | $312K |
| Long-term disability | PRUDENTIAL | 663 | $312K |
| Prescription drug | CIGNA HEALTH ADN LIFE INSURANCE COMPANY | 481 | $851K |
| Other(3 contracts, 2 carriers) | PRUDENTIAL | 663 | $385K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 674 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.